Retrosternal chest pain can occur for various reasons, including cardiac or heart-related issues and noncardiac conditions, such as gastroesophageal reflux disease (GERD).

Retrosternal chest pain refers to pain that occurs in the space behind the sternum. It is a more specific way to refer to chest pain.

Chest pain can stem from various conditions that affect the heart, lungs, muscles, skeletal system, or gastrointestinal (GI) tract.

This article reviews several potential causes of retrosternal chest pain and when to consult a doctor.

person with chest painShare on Pinterest
andreswd/Getty Images

Issues in the GI tract can lead to chest pain and may include gastritis and GERD.

Gastritis refers to inflammation of the stomach, with symptoms that include discomfort or pain in the chest. This condition may be acute or chronic, and its underlying causes can include infections and high alcohol intake.

GERD is a chronic medical condition where the contents of the stomach flow into the esophagus, or food pipe.

Symptoms include:

  • heartburn
  • a burning sensation in the chest
  • indigestion
  • a sour taste in the mouth
  • frequent belching
  • a persistent cough

GERD accounts for 20–60% of chest pain that is not due to cardiac problems.

GI-related chest pain can also stem from issues with the muscles in the esophagus, such as:

  • an inability of the muscles to contract, resulting in food getting stuck in the chest
  • over contraction of the muscles
  • spasms

Another possible cause is food pipe sensitivity, where acid or pressure causes discomfort or pain.

Learn more about a range of gastrointestinal conditions.

Conditions that affect the skeleton, muscles, or tendons of the chest can also lead to chest pain.

Costochondritis causes inflammation in the cartilage of the chest. It can result in chest pain that feels like a heart attack. Costochondritis is not a medical emergency, but it is best to seek medical attention to rule out a heart attack.

Pain behind the sternum can also stem from strains and other injuries that affect the chest.

A person should speak with a doctor if they do not know the source of the pain.

What are some more causes of rib cage pain?

Lung problems can lead to retrosternal chest pain in some people.

They include:

  • Pulmonary embolism: A pulmonary embolism occurs when a blood clot stops blood flow to part of the lung. It can cause chest pain and breathing difficulty.
  • Pneumonia: Pneumonia is a bacterial, viral, or fungal infection in lung tissue. It can cause chest pain, a buildup of fluid in the lungs, breathing difficulty, a cough, and other symptoms.
  • Lung cancer: Lung cancers start in the cells of the bronchi or lungs. As the tumor grows, it can cause symptoms that include chest pain, trouble breathing, and coughing up blood.

Learn more about lung cancer through our dedicated hub: A deeper look at lung cancer.

Problems with the heart can result in chest pain. Examples of these cardiac issues include:

  • Heart attack: Also known as myocardial infarction, a heart attack occurs when blood flow and oxygen to one or more areas of the heart stops. Symptoms include pain in the chest that radiates down the arm, fatigue, and nausea. People experiencing a heart attack require immediate medical attention.
  • Heart valve disease: Heart valve disorders are a type of heart disease in which problems with the heart valves stop blood from flowing effectively. Aortic stenosis is one example that often affects older adults. Symptoms include chest pain, fatigue, and other symptoms.
  • Pericarditis: Pericarditis is inflammation of the pericardial sac, which surrounds the heart.
  • Myocarditis: Myocarditis, or inflammation of the heart, often results from an infection. It commonly occurs in younger people but can happen at any age. Symptoms include chest pain and fever.

Is it a heart attack?

Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:

  • chest pain, pressure, or tightness
  • pain that may spread to arms, neck, jaw, or back
  • nausea and vomiting
  • sweaty or clammy skin
  • heartburn or indigestion
  • shortness of breath
  • coughing or wheezing
  • lightheadedness or dizziness
  • anxiety that can feel similar to a panic attack

If someone has these symptoms:

  1. Dial 911 or the number of the nearest emergency department.
  2. Stay with them until the emergency services arrive.

If a person stops breathing before emergency services arrive, perform manual chest compressions:

  1. Lock fingers together and place the base of hands in the center of the chest.
  2. Position shoulders over hands and lock elbows.
  3. Press hard and fast, at a rate of 100–120 compressions per minute, to a depth of 2 inches.
  4. Continue these movements until the person starts to breathe or move.
  5. If needed, swap over with someone else without pausing compressions.

Use an automated external defibrillator (AED) available in many public places:

  1. An AED provides a shock that may restart the heart.
  2. Follow the instructions on the defibrillator or listen to the guided instructions.
Was this helpful?

A panic attack is when a person experiences sudden fear or discomfort or feels as if they are losing control, with or without an apparent trigger or cause.

Physical symptoms can resemble those of a heart attack and include:

How do you stop a panic attack?

A person should seek medical attention if they have chest pain they cannot explain. A doctor can help determine the underlying cause and provide appropriate treatment.

Anyone who has symptoms of a heart attack needs immediate medical attention. Signs of a heart attack include:

  • feeling faint, weak, or lightheaded
  • chest pain or discomfort
  • discomfort or pain in the shoulders or arms
  • shortness of breath
  • jaw, neck, or back pain

If these signs and symptoms occur, someone should call 911.

When is jaw pain a sign of a heart attack?

Retrosternal chest pain can occur for several reasons, including heart, lung, muscle, and GI issues. It typically causes pain in the center of the chest.

A person needs to discuss chest pain with a doctor. Additionally, if anyone has symptoms of a heart attack, someone should call 911 immediately.